1.  We find it astonishing that the Minister was unable to provide information on the extent to which Government policy was being implemented. Moreover we note with concern the recent ACHCEW survey, A Friend in Need, casts considerable doubt on the extent to which NHS trusts have functioning PALS over the country as a whole. We call on the Minister now to collate and publish information on the implementation of PALS as a matter of urgency. (Paragraph 18)

2.  While we appreciate that the machinations of local government are more properly an issue for the Office of the Deputy Prime Minister, we find it totally unacceptable that the Department apparently does not have access to basic information about an element of public involvement in the NHS it clearly views as so crucial, three months after it should have been introduced. This is particularly worrying given the vital statutory function of Overview and Scrutiny Committees with respect to proposed closures and reconfigurations in the NHS. (Paragraph 19)

3.  We urge the Government to ensure that the establishment of Patient and Public Involvement Forums is fully completed by 1 December 2003, to avoid further confusion and uncertainty for patients and NHS staff. (Paragraph 28)

4.  We urge the Government, in line with commitments made in Parliament, to extend CHCs period of operation until 1 July 2004, by which time PPIFs will have had sufficient time to develop their own systems and will be operating at full capacity. (Paragraph 29)

5.  We were told by the then Secretary of State that the new arrangements proposed for Foundation Trusts represented a far better form of public involvement than PPIFs, a conclusion we were not able to accept in our report on Foundation Trusts. While we explored this issue at great length in our inquiry on Foundation Trusts, we feel it is necessary again to register our amazement that throughout the arduous and comprehensive discussions that preceded the introduction of the new system for patient and public involvement, the Government's plans for a second, more radical overhaul of patient involvement, through the establishment of Foundation Trusts with elected Boards of Governors, were never brought to light. Had the connections between these two divergent and conflicting policies on patient and public involvement been drawn out before the new system began to be implemented, the issue of how Boards of Governors and PPIFs might relate to each other and work together could have been very profitably explored, and perhaps a coherent policy involving the best elements of both could have been developed. As it is we are left with the impression that some policy within the Department of Health is formulated in total isolation from other policy, leading to the ridiculous situation the NHS and its patients are now faced with the introduction of two parallel but entirely different systems of patient and public involvement within the NHS within one year. (Paragraph 34)